Attachment 3 - Past Performance Questionnaire.doc

When filled in this document is source selection sensitive information iaw FAR 3.104

Attachment L – 1 – Past Performance Survey Packages

When filled in this document is source selection sensitive information iaw FAR 3.104

Attachment 3 – Past Performance Survey Packages

DEPARTMENT OF THE AIR FORCE

HEADQUARTERS 316TH WING (AFDW)

FOR OFFICIAL USE ONLY

The 316th Contracting Squadron of the Air Force District of Washington is in the process of selecting a contractor to support Roofing requirements at Andrews AFB, MD. The requirement is to provide replacement services, repair services, and new construction to various roofing systems to include, but not limited to, Built-Up Roofing (BURS), Standing Seam Metal Roofing (SSMR), Strip Shingles Roofing (SSR), and Modified Bitumen Sheet Roofing (MBSR) Systems.

One of the considerations in proposal evaluation is the verification of the offerors' past and present performance on contracts, which reflect the offeror's ability to perform on the proposed effort. We depend on information received from agencies such as yours, which have had first hand experience with an offeror, for the evaluation of the offeror's performance on those contracts.

Our areas of interest in the offeror are summarized in the enclosed questionnaire. We need your written response no later than the closing date of the Solicitation (please confirm this date by checking the solicitation). This schedule will allow us sufficient time to analyze the data prior to the start of negotiations.

To assist you in preparing your response and expediting your reply, the questionnaire may be filled out by hand and "faxed" to 301-981-1907 (Attention: Ryan M. Battad, SSgt, USAF) or emailed to ryan.battad@us.af.mil (send Courtesy Copy [CC] to Ms. Kerry Callahan, kerry.callahan@afncr.af.mil) Please use these same emails if you have any questions. Your completed questionnaire will become a part of the official Source Selection records.

Your help is greatly appreciated and your prompt response will be one of the keys to the successful and timely completion of this Source Selection.

//Signed//

RYAN M. BATTAD, SSgt, USAF

Contract Specialist

Attch: Past/Present Performance Questionnaire

PAST PERFORMANCE SURVEY

IN RESPONSE TO

SOLICITATION NO.: FA4416-08-R-0008

PROJECT: ANDREWS AFB ROOF IDC

A. NAME OF FIRM BEING EVALUATED:_______________________________________________

The above contractor has identified you and/or your company/agency as a reference for past performance information for the above referenced solicitation. Please complete this survey, evaluating the contractor’s performance under your contract, and return it to the 316th Contracting Squadron (Attn: SSgt. Ryan Battad) no later than 12:00 p.m. EST (Eastern Standard Time), 20 June 2008. Surveys can be submitted either via email at ryan.battad@us.af.mil and or via fax at tel. 301-981-1907. Please courtesy copy Ms. Kerry Callahan at kerry.callahan@afncr.af.mil with all electronic correspondence(s).

B. RESPONDENT INFORMATION:

Name and Title of Respondent: ___________________________________________________________

Company/Agency Name: ________________________________________________________________

Address: _____________________

Telephone Number: ___________________

Fax Number:

Email Address:

Contractor performed as the ( Prime Contractor ( Sub-Contractor

*Note 1: If contractor was the “Sub-Contractor,” please indicate only the portion of the work the contractor was responsible for and the dollar amount for which they were responsible.

*Note 2: If offeror holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

*Note 3: If contractor holds or has held other contracts with your agency/organization in the last 3 years, please complete separate evaluation forms for those contracts as well.

Project Title or Brief Description of Work:

Contract Number: ____________________

Total Contract Dollar Amount: $ __________________*

Contract Completion Period (exact dates): __________________________*

C. SOLICITATION-SPECIFIC QUESTIONS (check all applicable boxes):

1. The contract above performed work on the following roof systems:

· Built-Up (BURS)

· Standing Seam Metal Roofing (SSMR)

· Strip Shingles Roofing (SSR)

· Modified Bitumen Sheet Roofing (MBSR)

· Other (Please specify): _________________________________________

2. The contract above was for:

· Repair

· Construction

· Replacement

3. The location where the contract above was performed is a (please specify):

· Department of Defense installation: _____________________________

· Public entity location (i.e. federal, state, county, school districts, etc.): __________________

· Commercial entity location:______________________________

4. The work was completed within the original period of performance:

· Yes

· No (if the period of performance was extended/changed, please explain why, and how long was the extension, below):

C. PERFORMANCE INFORMATION: Choose, by circling, the number on the scale of 1-5 or N, that most accurately describes the contractor’s performance or situation. PLEASE PROVIDE A NARRATIVE EXPLANATION FOR ANY RATINGS OF 1 OR 2.

contractor were effective.

How would you rate the contractor's overall performance for this contract?

Remarks:

Remarks:

Remarks:

YES/NO

YES/NO

YES/NO

Please provide other additional information/comments, if any: ___________________________________